【摘要】 目的 观察桑白皮石膏汤联合阿奇霉素治疗痰热壅肺型社区获得性肺炎(Community acquired pneumonia, CAP)的临床效果。方法 选取2020年1月—2022年1月期间河南省周口市中医院收治的90例痰热壅肺型社区获得性肺炎患者，按随机数字表法分为西药组和联合组，每组各45例。西药组给予阿奇霉素治疗，联合组给予桑白皮石膏汤联合阿奇霉素治疗。治疗10 d后，观察比较两组患者临床症状消退时间、临床疗效，治疗前后中医证候积分、常规感染性指标[外周血白细胞(White blood cell, WBC)、C反应蛋白(C-reactive protein, CRP)、降钙素原(Procalcitonin, PCT)]及血清炎症因子[血清肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)、白细胞介素-6(Interleukin-6,IL-6)]水平。结果 治疗后联合组治疗临床总有效率95.56%(43/45)高于西药组80.00%(36/45),差异有统计学意义(P<0.05)。治疗后联合组临床症状咳嗽、肺部啰音、发热的消退时间较西药组降低，差异有统计学意义(P<0.05)。治疗后联合组中医证候积分与对照组比较明显降低，差异有统计学意义(P<0.05)。治疗后两组患者常规感染性指标PCT、CRP、WBC较治疗前降低，差异有统计学意义(P<0.05);且联合组低于西药组，差异有统计学意义(P<0.05)。治疗后两组患者血清炎症因子TNF-α、IL-6、MMP-9均较治疗前降低，差异有统计学意义(P<0.05);且联合组低于西药组，差异有统计学意义(P<0.05)。结论 桑白皮石膏汤与阿奇霉素联用能提高CAP的治疗临床有效率，且抗感染、抗炎效果显著，促进临床症状改善。更多还原

【Abstract】 Objective To observe the clinical effect of Sangbaipi Shigao decoction combined with azithromycin in the treatment of community-acquired pneumonia(CAP)with phlegm-heat obstructing lung.Methods Ninety patients with CAP with phlegm-heat obstructing lung admitted to Zhoukou Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were randomly divided into a western medicine group and a combination group according to the random number table method, with 45 cases in each group.The western medicine group was treated with azithromycin, while the combination group was treated with Sangbaipi Shigao decoction combined with azithromycin.After treatment of 10d, the fade time of clinical symptoms, clinical effects, and traditional Chinese medicine(TCM)syndrome scores before and after treatment of the two groups were compared.In addition, conventional infectivity indexes, including white blood cell(WBC),C-reactive protein(CRP),procalcitonin(PCT),as well as serum inflammatory factors, such as tumor necrosis factor-α(TNF-α),matrix metalloproteinase-9(MMP-9),interleukin-6(IL-6)were also compared.Results After treatment, the total effective rate of the combination group(95.56%)was higher than that of the western medicine group(80.00%),and the difference was statistically significant(P<0.05).The fade time of cough, lung rale, and fever in the combination group was shorter than that in the western medicine group(P<0.05).The TCM syndrome scores in the combination group were lower than those in the western medicine group(P<0.05).PCT,CRP,and WBC in the two groups were reduced(P<0.05),and those in the western medicine group were higher(P<0.05).In addition, TNF-α,IL-6,and MMP-9 in the two groups were decreased(P<0.05),and those in the western medicine group were higher(P<0.05).Conclusion Sangbaipi Shigao decoction combined with azithromycin can improve the effective rate in the treatment of CAP and has remarkable anti-infection and anti-inflammatory effects, which can improve clinical symptoms.更多还原